Superficial soft-tissue masses suggestive of recurrent malignancy: sonographic localization and biopsy

OBJECTIVE: We investigated the usefulness of high-resolution sonography to localize superficial soft-tissue masses and to guide needle sampling for recurrent malignancy. MATERIALS AND METHODS: High-resolution sonography (10-MHz) was used to locate and guide needle sampling of 16 palpable and eight impalpable superficial masses suggestive of recurrent malignancy in 23 patient (12 men, 11 women; 34-85 years old). After detection, 22 (92%) of the masses were immediately sampled by fine-needle aspiration with 18- to 25-gauge needles and two (8%) were sampled by a 20-gauge core gun. RESULTS: Diagnostic material was obtained without complication from all 24 masses and proved positive for recurrent disease in 13 (54%). Ten (63%) of 16 palpable and three (38%) of eight impalpable masses proved positive for recurrent malignancies. One third of superficial soft-tissue masses were detected by imaging only, and of the masses not revealed on imaging, three (23%) of 13 were the site of first recurrence. Most nonnodal superficial masses (8/13) were benign, unlike the lymph nodes, of which three (27%) of 11 were benign. CONCLUSION: Not all early recurrent malignancies within the skin and subcutaneous tissues are detected by clinical examination. High-resolution sonography provided us with a rapid, safe, and accurate means of localizing and then guiding needle biopsies of superficial soft-tissue masses suggestive of recurrent malignancy.